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Exercise

Understand Intensity

Understanding Exercise

For people with type 1 diabetes, aerobic exercise (like walking, jogging, and cycling) can lower glucose levels. Some anaerobic exercises (like sprinting and power-lifting) can raise glucose levels. But it can be hard to know how intense an activity is.

Here is a modified "Rating of Perceived Exertion (RPE)" scale to help understand what intensity you are exercising at:

  • Aerobic activities usually fall in the 2–8 range
  • Anaerobic activities usually fall in the 7–10 range

The type and intensity of exercise can affect glucose levels differently. Below, we describe different intensities of physical activity and how they may impact your glucose levels.

LOW TO MODERATE INTENSITY ACTIVITY

  • Glucose levels tend to drop with low-to-moderate intensity activity.
  • Your body uses up energy, and as you use it, you may experience low glucose levels.
  • You may need a snack before or during the activity to prevent lows.

MIXED ACTIVITY

  • A combination of low and high-intensity activity (sometimes in short bursts or intervals).
  • Mixed forms of exercise usually cause a smaller drop in glucose levels.
  • You may still need a snack before or during the activity to prevent lows.


HIGH-INTENSITY ACTIVITY

  • Very explosive, high-intensity, or anaerobic exercise may cause glucose levels to rise.
  • Maximum effort activity (to fatigue) can cause the liver to release more glucose than muscles take up.
  • Increases in stress hormones (like adrenaline) in the body may cause glucose levels to rise.
Below, we give examples of light-, moderate-, and vigorous-intensity activity for youth and adults living with diabetes. 

Intensities of Activity

Youth

Light-Intensity Activities (Activities of Daily Living/ADL's):

Walking to/from school

Walking in between classes

Stretching

Moderate-Intensity Activities

Physical education (PE) class activities

Playing on the playground

Volleyball

Soccer

Football

Basketball

Ultimate frisbee

Vigorous-Intensity Activities

Beep test at school (sprinting)

Mile run at school

Tag (a school game involving one or more players chasing other players in an attempt to "tag" and mark them out of play)

Intensities of Activity

Adult

Light-Intensity Activities (Activities of Daily Living/ADLs):

Walking

Getting groceries

Cutting the grass

Vacuuming

Doing laundry

Moderate-Intensity Activities

Walking briskly (2.5 miles per hour or faster)

Recreational swimming

Bicycling slower than 10 miles per hour on level terrain

Tennis (doubles)

Active forms of yoga (for example, Vinyasa or power yoga)

Exercise classes like water aerobics

Vigorous-Intensity Activities

Running

Bicycling faster than 10 miles per hour

Tennis (singles)

Visit these sections for more information

Barriers to Exercise

Pumps and Smart Pens for Activity

Glucose Monitoring Devices and Activity

Tips from the DiabetesWise Team

References

Adolfsson P, Taplin CE, Zaharieva DP, Pemberton J, Davis EA, Riddell MC, McGavock J, Moser O, Szadkowska A, Lopez P, Santiprabhob J, Frattolin E, Griffiths G, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Exercise in children and adolescents with diabetes. Pediatr Diabetes. 2022 Dec;23(8):1341-1372. doi: 10.1111/pedi.13452. PMID: 36537529; PMCID: PMC10107219.

Riddell MC, Gallen IW, Smart CE, Taplin CE, Adolfsson P, Lumb AN, Kowalski A, Rabasa-Lhoret R, McCrimmon RJ, Hume C, Annan F, Fournier PA, Graham C, Bode B, Galassetti P, Jones TW, Millán IS, Heise T, Peters AL, Petz A, Laffel LM. Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol. 2017 May;5(5):377-390. doi: 10.1016/S2213-8587(17)30014-1. Epub 2017 Jan 24. Erratum in: Lancet Diabetes Endocrinol. 2017 May;5(5):e3. PMID: 28126459

Zaharieva DP, Morrison D, Paldus B, Lal RA, Buckingham BA, O'Neal DN. Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes. Diabetes Spectr. 2023 May;36(2):127-136. doi: 10.2337/dsi22-0018. Epub 2023 May 15. PMID: 37193203; PMCID: PMC10182962.